RESUMEN
Sebaceous carcinoma of the eyelids is a rare malignancy of which most cases require extensive excision followed by usually complete eyelid reconstruction. We report a case developed from the Meibomius glands of the lower eyelid. Complete excision was achieved by removing the entire eyelid 'en bloc'. Reconstruction was with a composite, chondromucosal septal graft layered on an upper eyelid, musculocutaneous, transposition flap based on a lateral pedicle. After a brief review of the relevant literature, the advantages and disadvantages of the various methods of complete lower eyelid reconstruction are discussed.
Asunto(s)
Adenocarcinoma Sebáceo/diagnóstico , Adenocarcinoma Sebáceo/cirugía , Blefaroplastia/métodos , Neoplasias de los Párpados/diagnóstico , Neoplasias de los Párpados/cirugía , Glándulas Tarsales , Neoplasias de las Glándulas Sebáceas/diagnóstico , Neoplasias de las Glándulas Sebáceas/cirugía , Colgajos Quirúrgicos , Anciano , Biopsia , Humanos , Masculino , Tabique Nasal/trasplante , Tomografía Computarizada por Rayos XRESUMEN
We present a case report of an anterior gingival epithelioma cuniculatum in place of teeth 41 and 42, with osseous mandibular extension for which a one time reconstruction with an osteocutaneous free fibula flap was performed with three dental osseointegrated implants. We reviewed the literature on this type of carcinoma and discuss the diagnosis difficulty. Radical surgical treatment is required.
Asunto(s)
Carcinoma Verrugoso/patología , Neoplasias Gingivales/patología , Neoplasias Mandibulares/patología , Trasplante Óseo/métodos , Carcinoma Verrugoso/cirugía , Implantación Dental Endoósea , Implantes Dentales , Femenino , Peroné , Estudios de Seguimiento , Neoplasias Gingivales/cirugía , Humanos , Neoplasias Mandibulares/cirugía , Persona de Mediana Edad , Invasividad Neoplásica , Trasplante de Piel/métodos , Colgajos QuirúrgicosRESUMEN
We report a case of lichen planus in a patient with hepatitis C infection and discuss the relationship between these two diseases.
Asunto(s)
Hepatitis C Crónica/complicaciones , Liquen Plano Oral/complicaciones , Enfermedades de los Labios/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Estudios de Seguimiento , Hepatitis C Crónica/terapia , Humanos , Interferones/uso terapéutico , Liquen Plano Oral/cirugía , Enfermedades de los Labios/cirugía , Masculino , Persona de Mediana EdadRESUMEN
We report on Gorlin-Goltz syndrome observed in 4 patients belonging to three generations of the same family. We present the clinical findings and emphasize recent genetic discoveries. We discuss the difficulty in following these patients and propose a series of simple explorations which can be helpful.
Asunto(s)
Síndrome del Nevo Basocelular/genética , Carcinoma Basocelular/genética , Carcinoma Basocelular/patología , Neoplasias Faciales/genética , Neoplasias Faciales/patología , Femenino , Humanos , Quistes Maxilomandibulares/genética , Masculino , Enfermedades Mandibulares/genética , Persona de Mediana Edad , Costillas/anomalías , Neoplasias Cutáneas/genética , Neoplasias Cutáneas/patología , Disrafia Espinal/genéticaRESUMEN
Surgical management of obstructive sleep apnea remains a surgical challenge. Multidisciplinary collaboration is a fundamental element. We report the principles of management as proposed to the patient and preliminary results obtained in a series of 26 patients treated in the phase I of the Stanford protocol. Cure rate after this phase was 50%. Different research projects in this area are discussed.
Asunto(s)
Síndromes de la Apnea del Sueño/cirugía , Adulto , Anciano , Obstrucción de las Vías Aéreas/cirugía , Músculos Faciales/cirugía , Femenino , Estudios de Seguimiento , Humanos , Masculino , Métodos , Persona de Mediana Edad , Nariz/cirugía , Paladar Blando/cirugía , Polisomnografía , Respiración con Presión Positiva , Síndromes de la Apnea del Sueño/etiología , Síndromes de la Apnea del Sueño/fisiopatología , Síndromes de la Apnea del Sueño/terapiaRESUMEN
We report a case of bilateral switch nerve palsy following minor head trauma. We discuss available literature, frequency and pathophysiology of bilateral abducens nerve palsy after minor head trauma. We also present current knowledge of prognosis and treatment of oculomotor palsies after trauma.
Asunto(s)
Traumatismo del Nervio Abducente , Traumatismos Craneocerebrales/complicaciones , Parálisis/etiología , Accidentes de Tránsito , Anciano , Diplopía/etiología , Diplopía/terapia , Estudios de Seguimiento , Hematoma/complicaciones , Humanos , Masculino , Fracturas Maxilares/complicaciones , Seno Maxilar/lesiones , Oftalmoplejía/etiología , Oftalmoplejía/terapia , Fracturas Orbitales/complicaciones , Parálisis/terapiaRESUMEN
The osteocutaneous fibular free flap is one of the most useful flap for complex mandibular reconstruction. The authors summarize the surgical technique, giving a pre, per and postoperative strategy.
Asunto(s)
Trasplante Óseo/métodos , Mandíbula/cirugía , Trasplante de Piel/métodos , Colgajos Quirúrgicos , Anastomosis Quirúrgica , Disección , Peroné/irrigación sanguínea , Peroné/diagnóstico por imagen , Humanos , Cuidados Intraoperatorios , Osteotomía , Planificación de Atención al Paciente , Cuidados Preoperatorios , Ultrasonografía DopplerRESUMEN
Treatment of panfacial burns is a difficult challenge for the plastic surgeon. Although excision-grafting procedures can be used to provide sufficient skin of sufficient quality, inevitable skin retraction will, in the long run, produce the typical "burned face" aspect (retraction of the periorificial zones, smoothing out of the main skin folds). The grafted face then looks like a flat, rigid and unexpressive mask unable to perform its social function as an organ of expression and mimic. In order to reestablish the main facial features, we used sliding skin flaps which were either grafted immediately or during a second operation. We report here our experience and give details on the technical points and indications as well as the advantages and disadvantages of this method.
Asunto(s)
Quemaduras/cirugía , Procedimientos Quirúrgicos Dermatologicos , Traumatismos Faciales/cirugía , Colgajos Quirúrgicos , Adulto , Cicatriz/patología , Cicatriz/cirugía , Contractura/etiología , Contractura/cirugía , Cara/cirugía , Expresión Facial , Humanos , Reoperación , Trasplante de Piel/métodos , Cicatrización de HeridasRESUMEN
Several questions concerning the material to be used for surgical repair of fractures of the orbit are still under debate. Surgeons may choose between autologous or heterologous grafts or different biomaterials. We conducted a retrospective analysis of 137 patients treated in our unit for fractures of the floor of the orbit over the last 20 years who received a silastic implant. After 20 years, the rate of complications requiring removal of the implant was 13.8%. Complications observed were dacryocystitis, implant migration to the skin and the maxillary sinus, skin fistula, persistent diplopia, communication between the orbit and the sinus, periorbit cellulitis.
Asunto(s)
Fracturas Orbitales/cirugía , Prótesis e Implantes/efectos adversos , Elastómeros de Silicona/efectos adversos , Materiales Biocompatibles/efectos adversos , Trasplante Óseo , Celulitis (Flemón)/etiología , Fístula Cutánea/etiología , Dacriocistitis/etiología , Diplopía/etiología , Fístula/etiología , Estudios de Seguimiento , Migración de Cuerpo Extraño/etiología , Humanos , Seno Maxilar/patología , Enfermedades Orbitales/etiología , Enfermedades de los Senos Paranasales/etiología , Falla de Prótesis , Estudios Retrospectivos , Piel/patología , Trasplante Autólogo , Trasplante HeterólogoRESUMEN
Fractures of the orbital floor still raise unresolved therapeutic problems concerning the operative indication or the type of material to be used during repair. For this purpose, surgeons have the choice between heterologous or autologous grafts, implants and numerous biomaterials. The authors conducted a retrospective study with a follow-up of 20 years of 137 patients treated in the department for a fracture of the orbital floor using a Silastic implant. The reoperation rate to remove the implant was 13.8%. Various complications were observed: dacryocystitis, migration of the implant to the skin and maxillary sinus, cutaneous fistula, persistent diplopia, orbito-sinus communication, periorbital cellulitis. In view of these complications, it appears preferable to modify the therapeutic approach and propose autotransplantation of the concha for defects less than 1.5 cm2 and autologous parietal bone graft for larger defects.
Asunto(s)
Fracturas Orbitales/cirugía , Implantación de Prótesis/métodos , Adulto , Materiales Biocompatibles , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Estudios RetrospectivosRESUMEN
A 41-year-old woman progressively developed a painful tumefaction in the left temporal fossa. The scan showed a isodense intramuscular structure weakly enhanced by contrast medium. Surgical exeresis was performed via the coronal access. Histology of the surgical specimen reported the diagnosis of venous muscular haemangioma. The diagnosis and management of these rare tumours is discussed.
Asunto(s)
Hemangioma , Neoplasias de los Músculos , Músculo Temporal , Adulto , Diagnóstico Diferencial , Femenino , Hemangioma/patología , Hemangioma/cirugía , Humanos , Neoplasias de los Músculos/patología , Neoplasias de los Músculos/cirugía , Pronóstico , Músculo Temporal/patologíaRESUMEN
Recent progress in plastic surgery techniques have clearly contributed to the improvement of the aesthetic prognosis of facial burns. However, although current excision-graft techniques achieve good quality skin, often in sufficient quantity, these grafts give the face a fixed, inexpressive, flat mask appearance, du to the inevitable phenomena of scar retraction. To palliate this unsightly appearance of the grafted face, the authors restore the principal facial relief (eyebrows, cheekbones, nostrils, philtrum, lips, chin) by using, depending on the particular case, subperiosteal parietal bone grafts, or flaps of scar tissue grafted immediately or secondarily. The authors report their experience and describe the techniques, indications, as well as the advantages and disadvantages of these various procedures.
Asunto(s)
Quemaduras/cirugía , Traumatismos Faciales/cirugía , Cirugía Plástica , Huesos Faciales/cirugía , Humanos , Colgajos QuirúrgicosRESUMEN
For some years, breast cancer surgery has become increasingly conservative, in order to preserve the aesthetic aspect of the treated breast and global harmony of the bosom. Unfortunately, conservative treatment is followed by 20% to 30% of unsatisfactory cosmetic results. Some studies have defined the various factors associated with an increased failure rate in terms of cosmetic results. These are related to the surgical technique, patient characteristics, or tumor specificities. In these cases with a poor aesthetic prognosis, the authors propose, following the initial tumorectomy, esther breast reduction or mammaexy, in order to reshape the volume of the breast as symmetrically as possible. In a series of 21 female patients operated at the Institut Gustave-Roussy between 1988 and 1991, the authors describe the aesthetic and carcinologic advantages of this method, and define its main indications. Although the aesthetic aspect of the operated breast was considered tube excellent in 33% of cases and good in 67% of cases, the global harmony of the breasts was excellent or good in 76% of cases. The 24 moderate or poor results were due to asymmetry of shape or volume, which is easy to improve by a secondary contralateral breast reduction.
Asunto(s)
Neoplasias de la Mama/cirugía , Mamoplastia/métodos , Adulto , Anciano , Estética , Femenino , Humanos , Mamoplastia/psicología , Persona de Mediana EdadRESUMEN
Since the beginning of the sixties, plastic surgeons now use silicone gel prostheses, in aesthetic or reconstruction surgery, for augmentation mammaplasty. Organic complications occurring after the insertion of these implants are reported in the literature, due to the large number of women now treated. Out of the purely local complications, and the general complications related to silicone biocompatibility, some regional complications are described, such as silicone granuloma. Authors describe three cases of sicilone granuloma they have observed and cured. After a short review of the literature, they underline problems raised by silicone granuloma, such as those related to diagnostic and therapeutic approaches.